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Labour Dystocia (Failure to Progress, FTP)

Last updated 25.08.13

 

Index

 

Definition

- Delayed progression of labour & delivery

 

Features

- Delayed 1st Stage

-  Primiparous <2cm dilation in 4/24

-  Multiparous <2cm dilation in 4/24 or slowing of progress

- Delayed 2nd Stage

-  Primiparous suspected if no progress in 1/24

-  Multiparous 1/24 without birth

- Delayed 3rd stage = retained placenta

-  >30min post delivery of baby if active Mx 3rd stage

-  >60min post delivery of baby if physiological 3rd stage

 

Causes

-  Obstructed labour

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Associated S/S

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Complications

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Ix

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Mx

- Delayed 1st Stage

-  VE +/- ARM

-  Reassess (VE) in 2/24

-  <1cm change in dilation = delayed 1st stage

-   Nulliparous consider Syntocinon + continuous CTG

-   Muliparous abdo palp & consider Syntocinon

-   +/- offer Epidural prior to Syntocinon

-   Aim for 4-5 contractions per 10min w Syntocinon

-  >1cm change in dilation leave & repeat VE 2/24

-   <1cm = delayed 1st stage

-  Nulliparous consider Syntocinon + continuous CTG

-  Muliparous abdo palp & consider Syntocinon

-  +/- offer Epidural prior to Syntocinon

-  Aim for 4-5 contractions per 10min with Syntocinon

-  >2cm then reassess in 4/24

-  <2cm consider LUSCS

-   >1cm leave & repeat VE

- Delayed 2nd Stage

-  Nulliparous offer VE +/- ARM, consider analgesia/epidural

-  If no birth in 1/24 (total 2/24) = delayed 2nd stage

-  R/V every 15-30min

-  Instrumental birth if concerned re fetal well being or prolonged 2nd stage (2hrs multi, 3hrs primip)

-  OR LUSCS if instrumental not possible

- Delayed 3rd Stage = retained placenta